Department of Surgery, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, South Kivu, Democratic Republic of Congo.
Faculty of Medicine, Catholic University of Bukavu, Bukavu, South Kivu, Democratic Republic of Congo.
PLoS One. 2024 Oct 7;19(10):e0309004. doi: 10.1371/journal.pone.0309004. eCollection 2024.
Possible contamination related to mining activities might contribute with other risk factors in increasing the burden of birth defects (BDs) in many developing countries including the Democratic Republic of Congo. The subsequent prevalence is frequently underestimated. Implementation of focused public health interventions is hindered by the paucity of comprehensive data. We assessed the potential impact of mining on the prevalence and occurrence of visible BDs in neonates in South Kivu (SK).
A hospital-based cross-sectional study was conducted among 65,474 newborns registered in 7 hospitals in SK from 2016-2021. Hospitals were categorized based on mining activities in their respective catchment areas. Living in a mining zone was the exposure, whereas the outcome was visible BDs. Prevalence was estimated per 100,000 live births, and risk of occurrence with odds ratio (OR) and their 95% confidence interval.
261 neonates with visible BDs were recorded accounting for a prevalence of 399 cases per 100,000 live births. The prevalence ranges between 217 and 1365 cases per 100,000 live births. An increased risk was found in mining zones(OR=2.07; 95%CI=1.59-2.68), Mubumbano(OR=1.72, 95%CI=1.22-2.43), and Mwenga(OR=3.89, 95%CI=2.73-5.54), whereas a reduced risk was reported in non-mining zones(OR=0.48, 95%CI=0.37-0.62) in Katana (OR=0.49, 95%CI=0.33-0.73). Musculoskeletal(28.74%) and central nervous systems(19.92%) were the most common BDs. A significant difference in prevalence for BDs involving the face, GI system and abdominal wall, musculoskeletal, central nervous and genitourinary systems between mining and non-mining zones was found(p<0.001).
There is an excessive risk for visible BDs in areas with hazardous mining activities in SK region. More complex studies are needed to define the possible causal relationship. Moreover, findings generated herein should be corroborated by other research design, periodically monitored by public health authorities, and used to inform initiatives promoting enhanced environmental health, access to pediatric surgical care, and public health campaigns aimed at decreasing risk of BDs.
在许多发展中国家，包括刚果民主共和国，采矿活动可能导致的污染以及其他风险因素可能会增加出生缺陷（BDs）的负担。随后的流行情况经常被低估。由于缺乏全面的数据，实施有针对性的公共卫生干预措施受到阻碍。我们评估了采矿活动对南基伍省（SK）新生儿可见 BDs 的患病率和发生的潜在影响。
对 2016 年至 2021 年间在 SK 的 7 家医院登记的 65474 名新生儿进行了一项基于医院的横断面研究。根据各自集水区的采矿活动对医院进行了分类。居住在矿区是暴露因素，而可见 BDs 是结果。患病率按每 10 万活产儿计算，发生的风险用比值比（OR）及其 95%置信区间表示。
记录了 261 例有可见 BDs 的新生儿，患病率为每 100000 例活产儿 399 例。患病率范围在每 100000 例活产儿 217 例至 1365 例之间。在矿区（OR=2.07；95%CI=1.59-2.68）、Mubumbano（OR=1.72；95%CI=1.22-2.43）和 Mwenga（OR=3.89；95%CI=2.73-5.54）中发现风险增加，而在非矿区（OR=0.48；95%CI=0.37-0.62）中发现风险降低Katana（OR=0.49；95%CI=0.33-0.73）。骨骼肌肉系统（28.74%）和中枢神经系统（19.92%）是最常见的 BDs。矿区和非矿区之间的面部、胃肠道系统和腹壁、骨骼肌肉系统、中枢神经系统和泌尿生殖系统 BDs 的患病率存在显著差异（p<0.001）。
在南基伍地区危险采矿活动地区，可见 BDs 的风险过高。需要进行更复杂的研究来确定可能的因果关系。此外，公共卫生当局应定期监测和使用本文产生的结果，并以此为依据开展促进增强环境卫生、获得儿科外科护理和开展减少 BDs 风险的公共卫生运动的倡议。
